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"Economy Class" stroke syndrome?

From the Department of Neurology (Drs. Isayev and Chan), State University of New York at Buffalo; and Department of Neurosciences (Dr. Pullicino), New Jersey Medical School, Newark.

Address correspondence and reprint requests to Dr. Patrick M. Pullicino, Department of Neurosciences, New Jersey Medical School, Medical Science Building, 185 S. Orange Avenue, MSB-H506, Newark, NJ 07103-2714.

The authors report three cases of ischemic stroke in young adults that occurred during or after an airplane flight. Workup was negative for any cause of stroke other than the presence of a patent foramen ovale (PFO). There is an increasing awareness of deep vein thrombosis and pulmonary embolism occurring in relation to long flights. Individuals with a PFO under these circumstances may be vulnerable to stroke from paradoxic embolism. "Economy class" stroke syndrome may be underdiagnosed and is an eminently preventable cause of stroke.

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